3M 8000103 Manual De Usuario página 15

Inspection Date:
Components: Inspection:
Truck Hitch Davit Inspect the system for cracks, dents, or deformities.
Mount System
(Figure 1)
Inspect the entire unit for corrosion.
Labels (Figure 6)
Verify that all labels are securely attached and are legible (see 'Labels')
PFAS and Other
Additional Personal Fall Arrest System (PFAS) equipment (harness, SRL, etc) that are used
with the Truck Hitch Davit Mount should be installed and inspected per the manufacturer's
Equipment
instructions.
Serial Number(s):
Model Number:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
1 Competent Person:
One who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary,
hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.
Table 3 – Inspection and Maintenance Log
Inspected By:
(See Section 1 for Inspection Frequency)
User
Date Purchased:
Date of First Use:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Competent
Person
1